Executive-level experience within hospitals, health plans, pharmacy benefit management (PBM), disease & behavioral health management companies.

Key accomplishments include:

• Developing a care gap identification and notification system that lowers total cost trends by an average of 5% and preventable admissions by 10% for employers and health plans
  
  1. High impact combined with low cost due to automation results in ROI exceeding 20:1
• Formulary management (P&T Committee, physician education, coverage management) that resulted in cost trends significantly lower than national averages:
  
  1. Mease Healthcare had no increase for over 3 years versus >20% annual trends nationally
  2. CIGNA Healthplan of Florida had no increase for over 4 years versus >15% annual trends nationally
  3. PCN experienced trends 1/2 of the national average for 9 years
  4. Trigon experienced trends 1/2 of the national average for 3 years

Leading major IT projects, including:

• • Selection and transition from outsourced claims processing to ComCoTec (now Catamaran)
  • Selection and implementation of pharmacy computer systems for CIGNA’s staff-model clinics
  • Developed the MedIntelligence suite of decision support systems (DSS) for PCN
  • Selection and contracting for pharmacy DSS for Towers Perrin
  • Managing customer service, account management and clinical teams of up to 75 people with profit & loss responsibility (P&L) for budgets exceeding $300 million
  • Negotiating rebate (hospital, managed care), claims processing, PBM and decision support service contracts
  • Directly supporting sales teams, including achievement of personal sales goals while at Towers Perrin
    
    1. Managed multiple consulting projects each year while National Pharmacy Practice Leader at Towers Perrin
    2. The practice averaged 30% annual revenue growth while National Pharmacy Practice Leader (Towers Perrin)
    3. Over 90% of clients at Trigon used our pharmacy services compared to an average of ~50% for other health plans